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Comparison of Short-Term Surgical Outcomes of Two Types of Robotic Gastrectomy for Gastric Cancer: Ultrasonic Shears Method Versus the Maryland Bipolar Forceps Method

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Journal of Gastrointestinal Surgery

Abstract

Background

This study investigated the impact and short-term surgical outcomes of two different main energy devices for robotic gastrectomy for gastric cancer. The outcomes of robotic gastrectomy with ultrasonic shears and those of robotic gastrectomy with conventional forceps were compared.

Methods

We retrospectively evaluated 171 patients who underwent robotic distal gastrectomy or total gastrectomy for gastric cancer. We classified patients into the ultrasonic shears (US) and Maryland bipolar (MB) forceps groups according to the main energy device used for robotic gastrectomy.

Results

We extracted 58 patients from the US group and 58 patients from the MB forceps groups using propensity score matching. The total console time (310 min [interquartile range (IQR), 253–369 min] and 332 min, [IQR, 294–429 min]; p = 0.022) and the console time to gastrectomy (222 min [IQR, 177–266 min] and 247 min [IQR, 208–321 min]; p = 0.004) were significantly shorter in the US group than in the MB forceps group. Less blood loss occurred in the US group than in the MB forceps group (20 mL [IQR, 10–40 mL] and 30 mL [IQR, 16–80 mL]; p = 0.014). The postoperative complication rate and postoperative hospital stay length were similar between groups. A multivariate multiple linear regression analysis demonstrated that the use of an ultrasonically activated device was one an independent factor that reduced the operative time of robotic gastrectomy.

Conclusion

Using ultrasonic shears as the main energy device may contribute to better surgical outcomes after robotic gastrectomy for gastric cancer.

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Abbreviations

LG:

Laparoscopic gastrectomy

RG:

Robotic gastrectomy

US:

Ultrasonic shears

MB:

Maryland bipolar

DB:

Double bipolar

PS:

Performance status

DG:

Distal gastrectomy

TG:

Total gastrectomy

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Osaka City General Hospital, 2-13-22 Miyakojima Hondori, Miyakojima-Ku, Osaka City, Osaka, 534-0021, Japan

    Kenji Kuroda MD, PhD, Naoshi Kubo, Katsunobu Sakurai, Tsuyoshi Hasegawa, Ken Yonemitsu, Shuhei Kushiyama, Naoki Aomatsu, Takafumi Nishii & Akiko Tachimori

  2. Department of Gastroenterological Surgery, Izumi City General Hospital, Osaka, Japan

    Yutaka Tamamori

  3. Department of Gastroenterological Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan

    Yasuhiro Fukui & Kiyoshi Maeda

Authors
  1. Kenji Kuroda MD, PhD
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  2. Naoshi Kubo
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  3. Katsunobu Sakurai
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Contributions

Study conception and design: KK and NK.

Methodology: KK and NK.

Acquisition of data: KK, NK, KS, YT, TH, KY, SK, YF, NA, TN, AT, KM.

Analysis and interpretation of data: KK.

Resources: KK, NK, KS, YT, TH, KY, SK, YF, NA, TN, AT, KM.

Supervision: KM.

Drafting manuscript: KK.

Drafting and revisiting manuscript: NK.

Corresponding author

Correspondence to Kenji Kuroda MD, PhD.

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The authors declare no competing interests.

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Kuroda, K., Kubo, N., Sakurai, K. et al. Comparison of Short-Term Surgical Outcomes of Two Types of Robotic Gastrectomy for Gastric Cancer: Ultrasonic Shears Method Versus the Maryland Bipolar Forceps Method. J Gastrointest Surg 27, 222–232 (2023). https://doi.org/10.1007/s11605-022-05527-2

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